Appl Clin Inform 2021; 12(01): 164-169
DOI: 10.1055/s-0041-1723023
Case Report

A Perioperative Care Display for Understanding High Acuity Patients

Laurie Lovett Novak
1  Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Jonathan Wanderer
2  Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
David A. Owens
3  Vanderbilt University Owen Graduate School of Management, Nashville, Tennessee, United States
,
Daniel Fabbri
1  Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Julian Z. Genkins
4  Department of Medicine, University of California San Francisco, San Francisco, California, United States
,
Thomas A. Lasko
1  Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations
Funding L.L.N., D.O., D.F., J.W., and T.A.L. report grant R01 EB0020666 from the National Institute of Biomedical Imaging and Bioengineering.

Abstract

Background The data visualization literature asserts that the details of the optimal data display must be tailored to the specific task, the background of the user, and the characteristics of the data. The general organizing principle of a concept-oriented display is known to be useful for many tasks and data types.

Objectives In this project, we used general principles of data visualization and a co-design process to produce a clinical display tailored to a specific cognitive task, chosen from the anesthesia domain, but with clear generalizability to other clinical tasks. To support the work of the anesthesia-in-charge (AIC) our task was, for a given day, to depict the acuity level and complexity of each patient in the collection of those that will be operated on the following day. The AIC uses this information to optimally allocate anesthesia staff and providers across operating rooms.

Methods We used a co-design process to collaborate with participants who work in the AIC role. We conducted two in-depth interviews with AICs and engaged them in subsequent input on iterative design solutions.

Results Through a co-design process, we found (1) the need to carefully match the level of detail in the display to the level required by the clinical task, (2) the impedance caused by irrelevant information on the screen such as icons relevant only to other tasks, and (3) the desire for a specific but optional trajectory of increasingly detailed textual summaries.

Conclusion This study reports a real-world clinical informatics development project that engaged users as co-designers. Our process led to the user-preferred design of a single binary flag to identify the subset of patients needing further investigation, and then a trajectory of increasingly detailed, text-based abstractions for each patient that can be displayed when more information is needed.

Protection of Human and Animal Subjects

This project was approved by the Vanderbilt University Institutional Review Board.




Publication History

Received: 11 June 2020

Accepted: 22 December 2020

Publication Date:
03 March 2021 (online)

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